A customized approach

For most families, one autism diagnosis can be devastating. For Alexander and Jrawin Fernandez of Brooklyn Park, it was just the beginning. All four of their sons, ages 2 to 6, are on the "autism spectrum."

A few years ago, they thought their children might spend the rest of their lives unable to talk or care for themselves. Yet today, their eldest son, Joshua, is mainstreamed in kindergarten and headed for a gifted classroom next fall.

And they have high hopes for all their sons, thanks in part to a day treatment program at the Fraser Child & Family Center in Minneapolis. "We see progress every day," said Alexander Fernandez.

To some, the gold standard of treatment is 40 hours a week of intense therapy, known as Applied Behavior Analysis (ABA).

But Fraser, the oldest and largest autism program in Minnesota, doesn't buy that argument, says Shelly Brandl, the center's director. "We don't give one-size-fits-all," she said. "We vary the amount of time or the intensity depending on the needs of the child."

That can mean as little as one to two hours of therapy a week or half-day classes costing up to $20,000 a year, with the option of more treatment if needed.

The Fernandez boys, their parents say, have been thriving at Fraser, getting a mix of individualized and group therapies. The three youngest are in day treatment for 16 hours to 18 hours a week, while Joshua visits once a week after school.

At Fraser, the treatment is all about exposing them to new experiences in a controlled environment, to teach them how to cope in socially acceptable ways. But it is as much art as science, says Valerie Olheiser, a speech and rehabilitation therapist. "We get it right for about 50 percent of our kids."

On a recent afternoon, the boys' parents peeked through a window as 4-year-old Seth, who hates getting messy, slathered his hands in shaving cream alongside his twin brother, Elijah, in Fraser's "therapeutic gym." The couple watched in awe as the boys rolled up their sleeves and took turns "painting." A few minutes later, the twins helped clean up the mess and followed the adults to the sink to wash up. No tantrums. No meltdowns. No scenes.

"That," said their father, "was really impressive."

When they started, the Fernandezes had no idea how much progress their sons would make. Joshua, the eldest, didn't speak until he was 3 1/2. As a toddler, he rarely made eye contact with his parents.

Alexander, who immigrated from Liberia with his wife, admits he had a hard time coping with the diagnosis. "I denied Joshua's autism for the longest time," he said. "Nobody wants the label."

They started Joshua in speech and occupational therapy through the public schools and eventually got him into a day treatment program.

When he finally began talking, the words "started pouring out of him," said his mother. "It was like an explosion." They discovered, to their surprise, that he already knew how to count to 50, and even how to read. They didn't realize how much had sunk in until he could talk.

Meanwhile, the twins started showing some of the same symptoms -- the delayed speech, the strange behavior -- around age 2. Their parents wasted little time lining up evaluations and treatment. "I was on board a little quicker because I saw the progress that Joshua was making," said Alexander, who quit his job as a financial planner to take care of the boys.

Last year, Laurent, 2, joined his brothers at Fraser.

The transformation, their parents say, has been remarkable. Dinnertime used to be "like 'Animal House,'" their dad said, with someone constantly crying or jumping out of his chair. He and his wife wouldn't eat until the kids were done. Today, he said, "we're eating as a family."

Alexander said he was incredulous several weeks ago when he watched 4-year-old Seth, who could never stand to be around strangers, walk up to a little girl with a toy. "He said, 'Hello, my name is Seth, would you like to play with me?' My jaw is literally dropping."

Says his wife: "They've come a long way. That means whatever we've been doing has been working."